The goal of this research is to improve the quality of endoscopic examinations for the early detection and diagnosis of cancer in the upper airway, lungs, esophagus, stomach, duodenum, and colon. The accuracy and quality of diagnostic endoscopic examinations depend upon the technical coordination, the knowledge of endoscopic anatomy, and the physician's ability to recognize early signs of cancer. The earlier these skills can be acquired by the physician the greater the benefits are to the cancer patient. This project attempts to demonstrate that both time and clinical experience required to achieve endoscopic expertise can be reduced by incorporating a viewing session of self-instructional endoscopic videotape programs into the physician's preclinical training phase. These videotape programs include a systematic approach to endoscopic anatomy and examples of endoscopic pathology that should facilitate the development of visual discrimination skills. A\module of five videotape programs in bronchoscopic anatomy and pathology will be used to test the hypothesis on a sample of 60 or more residents/fellows located in 12 university medical centers. In addition, this project will develop and produce programs of similar design in other areas of endoscopy that have high incidence of cancer; produce and evaluate a self-assessment program in bronchoscopy for practicing physicians; and utilize appropriate methods to make the medical public aware of the training value and availability of these programs. (5)